Alcohol use and antiretroviral adherence: review and meta-analysis.
Alcohol use and antiretroviral adherence: review and meta-analysis.
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DOI：
10.1097/qai.0b013e3181b18b6e
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发表时间：
2009-10-01
期刊：
影响因子：
--
通讯作者：
Simoni JM
中科院分区：
文献类型：
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作者：
Hendershot CS;Stoner SA;Pantalone DW;Simoni JM
酒精使用经常被认为是不坚持高效抗逆转录病毒治疗(HAART)的一个因素。目前还没有对研究结果进行系统评估的努力。这一元分析通过汇总研究结果和检查潜在的调节因素，提供了酒精依从性的定量评估。文献搜索确定了40项合格研究，总计超过25,000名参与者。研究是根据几个方法变量进行编码的。在联合分析中，与戒酒者(或饮酒相对较少的人)相比，饮酒者被归类为忠诚者的可能性约为50%-60%[OR=0.548，95%CI：0.490-0.612]。符合国家酒精滥用和酒精中毒协会的危险饮酒标准或酒精使用障碍标准的问题饮酒的影响大小[OR=0.474，95%CI=0.408-0.550]大于反映任何饮酒或全球饮酒的影响大小[OR=0.604，95%CI=0.531-0.687]。有几个变量缓和了饮酒依从性。结果支持了酒精使用和药物不依从性之间显著而可靠的联系。方法学变量似乎缓和了这种联系，并可能导致研究之间的不一致。未来的研究将受益于确定酒精坚持联系的理论机制以及调解人和调解人的努力。
Alcohol use is frequently implicated as a factor in nonadherence to highly active antiretroviral therapy (HAART). There have not been efforts to systematically evaluate findings across studies. This meta-analysis provides a quantitative evaluation of the alcohol-adherence association by aggregating findings across studies and examining potential moderators. Literature searches identified 40 qualifying studies totaling over 25,000 participants. Studies were coded on several methodological variables. In the combined analysis, alcohol drinkers were approximately 50–60% as likely to be classified as adherent [OR = 0.548, 95% CI: 0.490–0.612] compared to abstainers (or those who drank relatively less). Effect sizes for problem drinking, defined as meeting the National Institute on Alcohol Abuse and Alcoholism (NIAAA) criteria for at-risk drinking or criteria for an alcohol use disorder, were greater [OR = 0.474, 95% CI = 0.408–0.550] than those reflecting any or global drinking [OR = 0.604, 95% CI = 0.531–0.687]. Several variables moderated the alcohol-adherence association. Results support a significant and reliable association of alcohol use and medication nonadherence. Methodological variables appear to moderate this association and could contribute to inconsistencies across studies. Future research would benefit from efforts to characterize theoretical mechanisms as well as mediators and moderators of the alcohol-adherence association.